Medical information questions

[HeronNS]

We know that prednisone suppresses cortisol production by the adrenal glands. I believe it also affects other hormones produced by this gland. Questions - do these other hormones also have trouble re-establishing as one tapers and could those insufficiencies cause troublesome symptoms? And, does prednisone affect any other organs directly or are various symptoms (like muscle weakness) knock on effects from the adrenal glands' reduced effectiveness?

[Celtic PMRGCAuk volunteer]

Heron, rather than having an effect on the body's organs, Prednisone/Prednisolone can interfere with body chemistry, making it difficult for the body to balance certain hormones, especially the hypothalamus-pituitary-adrenal axis. After long-term Pred, the body needs time to balance these hormones and until that happens there could be a knock-on effect, including muscle weakness from the long term treatment. This is why we often say that it can take a year or more after coming off steroids for our bodies to return to normal.

[HeronNS in reply to Celtic]

Thanks Celtic. All I can find that looks like something useful to know is the recommendation to take DHEA to help deal with effects on the endocrine and immune systems, bone health and a few other things. Wouldn't that kind of information be a little better than the casual instruction we get to take calcium and vitamin D (and sometimes a bisphosphonate) and, by the way, get off pred asap! Anyway, now to do a little research on DHEA!

[HeronNS in reply to HeronNS]

Okay, scratch DHEA. Better just to keep tapering the pred!

[Ida-June128 in reply to HeronNS]

What is DHEA please?

[Celtic PMRGCAuk volunteer in reply to Ida-June128]

Ida-June, probably easier to read all about it on the following link (a reliable site for information): mayoclinic.org/drugs-supple....

Not enough research available so avoid it in my opinion. As with any supplement, either purchased over the counter or on prescription, always check with the pharmacist for any possible interaction with steroids.

[PMRpro Ambassador in reply to HeronNS]

I don't think it is a "casual instruction" to take calcium and vit D - that has been shown in clinical studies to reduce the rate of loss of bone density, in some cases patients' bone density even increased while taking them while on pred. And it is included in the international guidelines.

DHEA however is yet another of the myriad supplements that various people claim will cure a lot of things. There are no reputable blinded or crossover clinical trials which have been done to acceptable standards. That's why these supplements aren't suggested to us.

[HeronNS in reply to PMRpro]

Yes, (re DHEA) I got that after doing more reading. This is the reason I was asking more questions:

ncbi.nlm.nih.gov/pubmed/165...

And this is why I decided not to pursue the matter:

nlm.nih.gov/medlineplus/dru...

And I DO think the advice about calcium IS a bit casual as we aren't given enough information to help us get the most benefit from that calcium and D. No doubt it's because the doctors don't know enough either, not that they are making assumptions that we know more than we do.